Characteristics of Addiction

6 Key excerpts on "Characteristics of Addiction"

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  eBook - ePub

  The SAGE Handbook of Drug & Alcohol Studies

  Social Science Approaches

  • Torsten Kolind, Betsy Thom, Geoffrey Hunt(Authors)
  • 2016(Publication Date)
  • SAGE Publications Ltd

    (Publisher)

  4 Psychological Explanations of Addiction

  Robert Hill and Jennifer Harris

  Introduction

  Terms such as ‘addiction’, ‘dependence’ and ‘excessive appetites’ are used to describe an individual’s overwhelming, intense desire to engage in a particular behaviour, despite the negative consequences of doing so. Addiction is typically thought of as relating to psychoactive substances but encompasses other behaviours that can become compulsive such as eating, gambling, sexual activity, exercising and shopping. While these behaviours are thought to share similar psychological processes, psychoactive substances exert an additional unique neurobiological impact on the brain, psyche and body. With repeated use, the body and mind can adapt to the substance so that, if prevented from taking the substance, they can enter a withdrawal state. This triggers the urge to use in order to gain relief and regain equilibrium. Tolerance develops so that the individual experiences the need for increasingly frequent doses of the substance to maintain biological, neurological and psychological homeostasis. Alongside the typical cycle of craving, substance-seeking and use, relief and withdrawal, there is a concomitant narrowing of interests, social contact and lifestyle in order to focus on the substance. It may seem perplexing that the behaviour continues despite the dwindling positive effects of substance use over time, together with the considerable negative impact on physical and mental health, social, financial and legal aspects of life. Moreover, substance dependence has historically been viewed in terms of a chronic relapsing condition with periods of remission and relapse. The two major psychiatric diagnostic systems, the World Health Organisation's International Classification of Mental and Behavioural Disorders (ICD-10; WHO, 1992) and the American Diagnostic and Statistical Manual of Mental Disorders, Version 5 (DSM-5; APA, 2014), clearly describe the above physiological, behavioural, cognitive and social features of excessive and dependent substance use.

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  eBook - ePub

  Personality and Psychological Disorders

  • Gordon Claridge, Caroline Davis(Authors)
  • 2013(Publication Date)
  • Routledge

    (Publisher)

  Therefore, and in our discussions about addiction in the remainder of this chapter, we will adopt the perspective that addiction is not just about drug-taking, but rather that it comprises any behaviour that has the potential to become excessive, and that satisfies the set of commonly agreed criteria for addiction. Nevertheless, by adopting this broader viewpoint, we risk another difficulty – that of knowing where to draw the line between those behaviours that often cause addiction, and those that seldom do. For example, some have argued that it is possible to become addicted to work and to television – even to various forms of exercise, such as rock climbing (McIlwraith, 1998; Burke, 2000)! Although that may be true at one level, it is also clear that these activities do not share the same qualities as the core addictions, such as drug-taking, alcohol consumption, smoking, and gambling, both in terms of their reinforcing properties and in the strength of their addictive potential (see Orford, 2001). Clinical Features Although the experts have not reached complete consensus on the defining Characteristics of Addiction – nor on how they should be ordered by importance – at least most agree there are certain factors that should be included. Foremost is their progressively compulsive nature, even in the face of adverse consequences to health, safety, and social relations (Berridge & Robinson, 1995). In other words, to the serious detriment of conventional daily pursuits, such as looking after the needs of one’s family, functioning well at one’s job, and attending to normal social obligations, the addict spends more and more time carrying out the behaviour or seeking opportunities to do so. Nor is the addict deterred by the knowledge that the behaviour can cause serious medical problems, for example in the case of smoking. Tolerance is also a defining characteristic of addiction and describes the experiential changes that occur as a result of chronic overindulgence

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  eBook - ePub

  Drugs without the hot air

  Making sense of legal and illegal drugs

  • David Nutt(Author)
  • 2020(Publication Date)
  • UIT Cambridge

    (Publisher)

  Chapter 9. What is addiction? Is there an “addictive personality”?

  Using substances from outside the body to change our brain chemistry is something humans have always done, and the psychoactive effects created are similar to the changes we experience when we eat nice food or take exercise. For the majority of people the majority of the time, this doesn’t lead to compulsive behaviour – we remain in control, and pretty soon our brains return to their prior state. For a minority, however, drug use leads to drug abuse and addiction, just as a minority of people become addicted to food, gambling or sex. For these people, satisfying their cravings for whatever it is they’re addicted to becomes the most powerful source of motivation in their lives, overpowering every other need and often leading them to harm themselves and others.

  There are three elements that affect whether a person becomes addicted to a particular drug (Figure 9.1 ):

  Figure 9.1: The three elements that affect whether a person becomes addicted to a particular drug.

  1. Drug-related factors include how the drug reaches the brain, and what it does when it gets there. Tolerance and withdrawal also affect its addictiveness.

  2. Social factors include the availability and acceptability of using the drug, the prevalence of advertising, how the drug makes groups behave, and the economic and social costs.

  3. Personal and biological factors are those such as age, gender and genetics.

  In this chapter we look at the mechanisms of addiction, tolerance and withdrawal, and why certain people seem to have “addictive personalities”. (Chapter 4 has already examined some of the drug-related factors, which we explore in more detail in chapter 11 , and we cover the social factors in chapter 12 .)

  Addiction in history

  Our understanding of addiction has increased as more drugs have become available, and as their role in society has changed. Until the 19th century, heavy drinking or use of other drugs wasn’t seen as a special category of behaviour, but as a sin of excess, similar to overeating – gluttony was a problem because you were eating too much , not because food itself was a bad thing. Although excessive use of drugs was seen as problematic, the majority of people usually didn’t have access to enough potent substances to have that problem. An exception was the † Gin Craze of the 18th

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  eBook - ePub

  Addictions

  • Maree Teesson, Wayne Hall, Heather Proudfoot, Louisa Degenhardt(Authors)
  • 2013(Publication Date)
  • Psychology Press

    (Publisher)

  Key pathways in the brain are involved in substance use and dependence, and changes occur in the brain's balance and neurotransmitter function after chronic drug use. A variety of factors appear to explain why some people become dependent on drugs. Genetic factors appear to play a part in developing dependence on many of the most commonly used licit and illicit substances. Certain environmental factors also increase the likelihood of problematic substance use, such as economic disadvantage, family conflict, modelling of drug use, or parents’ permissive attitudes towards drug use, as well as conduct and emotional problems at an early age.

  Psychological approaches to the issue of substance dependence have attempted to explain some of the behavioural and cognitive phenomena thought to underlie problematic substance use. Some theories – such as those proposing a personality type more disposed to addiction, or those characterizing the “rational” addict – have played less of a role in clinical responses to addiction. Learning theories have played more of a role because learning plays an important role in the development and maintenance of substance use problems and learning may also be used to overcome these problems.

  Explanations of why some people become dependent on psychoactive substances vary in the level of explanation – biological, psychological, or sociocultural – but all have been supported by empirical research. Comprehensive theories, such as that proposed by West, are providing useful syntheses of these explanations that may assist clinicians in treating addictive disorders.

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  eBook - ePub

  Myth of Addiction

  Second Edition

  • John Booth Davies(Author)
  • 2013(Publication Date)
  • Routledge

    (Publisher)

  This variability creates the final dilemma. If, as seems to be the case, there is variability in severity of withdrawals as a function of time, place, expectation or whatever, then it becomes increasingly difficult to conceptualise withdrawals as the basic powerhouse or engine-room for ‘addictive’ behaviour. Furthermore, since we have argued that ‘craving’ lacks its essential property of compulsion, so ‘addiction’ becomes less monolithic and more amenable to explanation in human terms.

  Cures for Taking Drugs

  Returning to our main theme, it is suggested that the concept of ‘addiction’ might conceivably have some value if it gave emphasis to the normal and nonpathological decisions people make about drugs; but in fact it is usually employed to encapsulate certain assumptions about what drugs do to people, thereby implying a process from which the powers, wishes and intentions of the drug user are specifically excluded. The idea that the pharmacology of drugs makes people into addicts against their ‘will’ has to be contrasted with the idea that people make addicts of themselves because they choose to do so. The latter is a challenging suggestion which deserves serious consideration, and it certainly makes sense of the fact that treatment for addictions frequently seems to have more in common with procedures for attitude change, than with medical intervention.

  From such a standpoint, the term ‘addiction’ appears to refer not so much to some medical condition as to certain disapproved-of ways of thinking and deciding, certain acts of choice which are not qualitatively or quantitatively different from thinking, deciding and choosing in any other area of human life, but which happen to involve drugs. Because of the pharmacological action of drugs, the consequences can be disastrous to health, family and all aspects of living, but such consequences do not in themselves warrant the postulation of a special state which compels their use. Furthermore, there is no cure for drug taking because there is fundamentally nothing to be cured; no more in fact than there is a cure for rock climbing, football, or playing the violin. But if there are reasons for supposing that in a given case the rock climbing, football, or violin-playing are resulting in social and economic problems for the individual and for others, one might try to persuade him/her to reappraise the basis on which they make their decisions.

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  eBook - ePub

  Principles of Addiction

  Comprehensive Addictive Behaviors and Disorders, Volume 1

  • (Author)
  • 2013(Publication Date)
  • Academic Press

    (Publisher)

  It is generally agreed that a craving is primarily a relatively intense need, urge, or strong desire to undertake a target behavior. Cravings vary in intensity, but at their most intense, are often described by those who experience them as being overwhelming, provoking to some degree a loss of control over one’s reactions. Many definitions of craving often incorporate some component of perceived loss of control over one’s behavior. One may desire an ice cream, for example, but unlike a craving, such desires do not generally rise to the level where they are disruptive to other facets of life.

  Conceptually, craving is often thought of as a withdrawal effect; that is, simply a product of abstinence from a target behavior or substance. For example, a typical physiological model of drug craving would posit that dependent individuals have become tolerant to the presence of a drug, resulting in changes in the very physiology of the brain (e.g. through changes in the number and/or sensitivity of receptors) and, as a result of these changes, they experience craving when the drug is not available in sufficient quantities. Within such a framework, craving is thought to follow a similar time course to withdrawal symptoms during periods of abstinence. Typically, drug withdrawal symptoms increase with the duration of abstinence before peaking and then gradually returning to baseline levels (although researchers have identified a number of unique time profiles of withdrawal symptoms that do not follow this trajectory). Supporting such a conceptualization, there is strong evidence from numerous studies across many drugs of dependence that the experience of craving does vary predictably with abstinence (typically increasing within the hours following cessation of drug use before tapering back to baseline levels gradually over subsequent days and weeks).

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